Organization
PRIME LIFE COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PRIMEAUX LCPC, NCC, ATR (OWNER/CLINICIAN)
(316) 655-1376
Entity
Organization
Contact information
Practice address
9350 E CORPORATE HILLS DR UNIT 780791, WICHITA, KS 67278-0100
(316) 655-1376
Mailing address
9350 E CORPORATE HILLS DR UNIT 780791, WICHITA, KS 67278-0100
(316) 655-1376
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LCPC2512
—
KS
Enumeration date
09/11/2018
Last updated
07/16/2021
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